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Serving Our Community
Addressing Disparities in Diabetes Care and Outcomes
Health Equity Monthly Focus
By Anita Ramsetty, MD, Director of Health Equity
November 2024
November is National Diabetes Awareness Month. While medical science has made some enormous strides regarding available treatments for type 1 and type 2 diabetes in the past 30-40 years, there continue to be differences in who receives and benefits most from those treatments. As a result, there are disparities in who suffers more from the consequences of a chronic disease like diabetes.
Medications like Ozempic made headlines for being out of stock, with rumors circulating about who could access them. Less widely reported, but perhaps more impactful, is the fact that insulin prices have remained too high for many patients. This has been frequently cited as a key reason for poor diabetes control among those who are uninsured, underinsured, or within lower income levels. As diabetes becomes increasingly difficult to control, people’s health declines, reducing their ability to engage in productive work. They miss more workdays and spend more time in emergency rooms and hospitals, leading to additional costs. This situation clearly illustrates how inequity—in this case, limited access to insulin for essential treatment—can lead to a downward cycle that affects many individuals. Across the country, the percentage of people living with diabetes varies by state, ranging from 6.6% in Colorado to 13.4% in West Virginia, according to 2020 census data. Access to insulin, a critical medication, impacts millions.
Thankfully, in the past four years Congress has passed several measures making insulin more affordable for many more people, including notably those covered by Medicare. It is not perfect, but it is much improved access at least for the time being. Large disparities, however, still persist in groups of individuals including non-White Hispanics, Blacks and those living in rural areas. These disparities are reflected in referrals for diabetes technology including insulin pumps and continuous glucose monitors, as well as receiving specialty care.
Diabetes is a chronic condition for most people, requiring lifelong management after diagnosis. Ensuring equitable access to care can lessen the burden of the disease and facilitate healthier, longer lives free of complications.